Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-586b7cd67f-2plfb Total loading time: 0 Render date: 2024-11-28T13:32:56.788Z Has data issue: false hasContentIssue false

Chapter 30 - Anesthetic Emergencies

Published online by Cambridge University Press:  24 May 2023

By
Eric Fried  and
Aaron Reagan
Edited by
Alan David Kaye  and
Richard D. Urman
Alan David Kaye
Affiliation:
Louisiana State University School of Medicine
Richard D. Urman
Affiliation:
Brigham and Women’s Hospital, Boston
Get access

Summary

Many anesthetic emergencies can be avoided with constant vigilance. However, the most effective way to prevent an anesthetic emergency is through preparedness. Adopting a methodological approach to verifying drugs and dosages and ensuring that syringes are well labeled can prevent many emergencies. Preparedness is key because equipment will malfunction, difficult airways will be encountered, and emergencies will occur; however, multistep preparations can make all the difference during stressful situations. This chapter provides an overview of the intraoperative management of anesthetic emergencies, including a brief discussion of Advanced Cardiac Life Support (ACLS) as it applies in the operating room, and a guide to assessing an unstable intraoperative patient, and concludes with a survey of various intraoperative emergencies [1].

Type
Chapter
Information
Cambridge Handbook of Anesthesiology , pp. 460 - 471
Publisher: Cambridge University Press
Print publication year: 2023

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Panchal, AR, Berg, KM, Kudenchuk, PJ, et al. 2018 American Heart Association focused update on advanced cardiovascular life support use of antiarrhythmic drugs during and immediately after cardiac arrest: an update to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2018;138(23):e740–9. [See Figure 2.]Google Scholar
Moitra, VK, Gabrielli, A, Maccioli, GA, O’Connor, MF. Anesthesia advanced circulatory life support. Can J Anaesth. 2012;59(6):586–603.Google Scholar
Sutherasan, Y, Vargas, M, Brunetti, I, Pelosi, P. Ventilatory targets after cardiac arrest. Minerva Anestesiol. 2015;81(1):39–51.Google Scholar
Panchal, AR, Berg, KM, Hirsch, KG, et al. 2019 American Heart Association focused update on advanced cardiovascular life support: use of advanced airways, vasopressors, and extracorporeal cardiopulmonary resuscitation during cardiac arrest: an update to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2019;140(24):e881–94.Google Scholar
Hayter, MA, Pavenski, K, Baker, J. Massive transfusion in the trauma patient: continuing professional development. Can J Anaesth. 2012;59(12):1130–45.Google Scholar
Eckel, AM, Hess, JR. Transfusion practice in trauma resuscitation. South Med J. 2017;110(8):554–8.Google Scholar
Unruh, M, Reyes, J, Helmer, SD, Haan, JM. An evaluation of blood product utilization rates with massive transfusion protocol: before and after thromboelastography (TEG) use in trauma. Am J Surg. 2019;218(6):1175–80.Google Scholar
Gonzalez, E, Moore, EE, Moore, HB, et al. Goal-directed hemostatic resuscitation of trauma-induced coagulopathy: a pragmatic randomized clinical trial comparing a viscoelastic assay to conventional coagulation assays. Ann Surg. 2016;263(6):1051–9.Google Scholar
De Wel, B, Claeys, KG. Malignant hyperthermia: still an issue for neuromuscular diseases? Curr Opin Neurol. 2018;31(5):628–34.Google Scholar
Cieniewicz, A, Trzebicki, J, Mayzner-Zawadzka, E, Kostera-Pruszczyk, A, Owczuk, R. Malignant hyperthermia – what do we know in 2019? Anaesthesiol Intensive Ther. 2019;51(3):169–77.Google Scholar
Rosenberg, H, Davis, M, James, D, Pollock, N, Stowell, K. Malignant hyperthermia. Orphanet J Rare Dis. 2007;2:21.Google Scholar
Childs, SG. Tension pneumothorax: a pulmonary complication secondary to regional anesthesia from brachial plexus interscalene nerve block. J Perianesth Nurs. 2002;17(6):404–10; quiz 410–12.Google Scholar
Blaivas, M, Lyon, M, Duggal, S. A prospective comparison of supine chest radiography and bedside ultrasound for the diagnosis of traumatic pneumothorax. Acad Emerg Med. 2005;12: 844–9.Google Scholar
Palmon, SC, Moore, LE, Lundberg, J, Toung, T. Venous air embolism: a review. J Clin Anesth. 1997;9(3):251–7.Google Scholar
Yeakel, AE. Lethal air embolism from plastic blood-storage container. JAMA. 1968;204:267–9.Google Scholar
Sato, S, Toya, S, Ohira, T, Mine, T, Greig, NH. Echocardiographic detection and treatment of intraoperative air embolism. J Neurosurg. 1986;64(3):440–4.Google Scholar
Schonberger, RB, Haddadin, AS. The anesthesia patient with acute coronary syndrome. Anesthesiol Clin. 2010;28(1):55–66.Google Scholar
Margolis, AM, Kirsch, TD. Tube thoracostomy. In: Roberts, JR, ed. Roberts and Hedges’ Clinical Procedures in Emergency Medicine and Acute Care, 7th ed. Philadelphia, PA: Elsevier; 2019, pp. 196–220.Google Scholar
Dhami, S, Panesar, S, Roberts, , et al.; EAACI Food Allergy and Anaphylaxis Guidelines Group. Management of anaphylaxis: a systematic review. Allergy. 2014;69:168–75.Google Scholar
Johansson, SG, Hourihane, JO, Bousquet, J, et al. A revised nomenclature for allergy. An EAACI position statement from the EAACI nomenclature task force. Allergy. 2001;56:813–24.Google Scholar
Dong, SW, Mertes, PM, Petitpain, N, Hasdenteufel, F, Malinovsky, JM ; GERAP. Hypersensitivity reactions during anesthesia. Results from the ninth French survey (2005–2007). Minerva Anestesiol. 2012;78(8):868–78.Google Scholar
Miyazaki, Y, Sunaga, H, Kida, K, et al. Incidence of anaphylaxis associated with sugammadex. Anesth Analg. 2018;126(5):1505–8.Google Scholar
Takazawa, T, Mitsuhata, H, Mertes, PM. Sugammadex and rocuronium-induced anaphylaxis. J Anesth. 2016;30(2):290–7.Google Scholar
Schwartz, LB, Metcalfe, DD, Miller, JS, Earl, H, Sullivan, T. Tryptase levels as an indicator of mast-cell activation in systemic anaphylaxis and mastocytosis. N Engl J Med. 1987;316:1622–6.Google Scholar
Gilstad, CW. Anaphylactic transfusion reactions. Curr Opin Hematol. 2003;10(6):419–23.Google Scholar
El-Boghdadly, K, Pawa, A, Chin, KJ. Local anesthetic systemic toxicity: current perspectives. Local Reg Anesth. 2018;11:35–44.CrossRefGoogle ScholarPubMed
O’Connor, CJ, Tuman, KJ. The intraoperative management of patients with pericardial tamponade. Anesthesiol Clin. 2010;28(1):87–96.Google Scholar
Khanna, S, Maheshwari, K. Hemopericardium and acute cardiac tamponade. Anesthesiology. 2018;128:1006.Google Scholar
Spodick, DH. Acute cardiac tamponade. N Engl J Med. 2003;349(7):684–90.Google Scholar
Bhananker, SM, Posner, KL, Cheney, FW, Caplan, RA, Lee, LA, Domino, KB. Injury and liability associated with monitored anesthesia care: a closed claims analysis.Anesthesiology. 2006;104(2):228–34.Google Scholar
Leung, AM. Thyroid emergencies. J Infus Nurs. 2016;39(5):281–6.Google Scholar
Alkhuja, S, Pyram, R. In the eye of the storm: iodinated contrast medium induced thyroid storm presenting as cardiopulmonary arrest. Heart Lung. 2013;42(4):267–9.CrossRefGoogle ScholarPubMed

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×